Coagulant and fibrinolytic status in tuberculous meningitis
Date
2007
Authors
Schoeman J.
Mansvelt E.
Springer P.
Van Rensburg A.J.
Carlini S.
Fourie E.
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
BACKGROUND: The long-term neurologic sequelae of childhood tuberculous meningitis (TBM) mainly result from ischemia owing to cerebral vasculitis. Deep vein thrombosis occurs in adults with pulmonary tuberculosis owing to hypercoaguability. The present study aimed to investigate coagulation status during acute childhood TBM. METHODS: Coagulation status, including the natural anticoagulants, antithrombin, protein C and protein S; procoagulant FVIII; fibrinolytic factors, tissue plasminogen activator and plasminogen activator inhibitor-1 (PAI-1) as well as anticardiolipin antibodies (ACA), was determined in 16 children with TBM before and during treatment. RESULTS: A prothrombotic profile was found as expressed by a decrease of anticoagulant (protein S) and increase of the procoagulant (factor VIII) activity. Raised PAI-1 and normal tissue plasminogen activator values indicated deficient fibrinolysis. This hypercoagulable state was more pronounced in stage 3 patients than in stage 2 patients. The bleeding time on admission ranged from 1.2 to 10 minutes [mean 4.2 minutes]. The mean platelet count on admission was 577.9 ± 188.6 × 10/L and increased further during the course of the treatment. CONCLUSIONS: The hypercoagulable state in childhood TBM is comparable to that described in adults with pulmonary tuberculosis and may further increase the risk for infarction. Therapeutic measures that reduce the risk for thrombosis could therefore be potentially beneficial in childhood TBM. © 2007 Lippincott Williams & Wilkins, Inc.
Description
Keywords
anticoagulant agent, antithrombin, blood clotting factor 8, cardiolipin antibody, ethionamide, fibrinolytic factor, isoniazid, plasminogen activator inhibitor 1, prednisone, protein C, protein S, pyrazinamide, rifampicin, tissue plasminogen activator, acute disease, adulthood, article, bleeding time, blood clotting, blood clotting test, cardiovascular risk, child, childhood disease, controlled study, disease severity, fibrinolysis, heart infarction, human, hypercoagulability, infant, lung tuberculosis, major clinical study, priority journal, risk factor, thrombocyte count, treatment outcome, tuberculous meningitis, Aspirin, Blood Coagulation, Child, Child, Preschool, Fibrinolysis, Humans, Infant, Platelet Count, Thrombolytic Therapy, Tuberculosis, Meningeal
Citation
Pediatric Infectious Disease Journal
26
5
26
5